Journal of Affective Disorders
Volume 78, Issue 1 , Pages 73-80 , January 2004

Burden of dysthymia and comorbid illness in adults in a Canadian primary care setting: high rates of psychiatric illness in the offspring

  • Barbara Bell

      Affiliations

    • System-Linked Research Unit on Health and Social Service Utilization, McMaster University, Faculty of Health Sciences, 1200 Main Street West, HSC-3N46, Hamilton, Ontario, Canada L8N 3Z5
    • The Caroline Medical Group, Burlington, ON, Canada
    • Department of Community Health and Family Medicine, The University of Toronto, Toronto, ON, Canada
  • ,
  • Lori Chalklin

      Affiliations

    • System-Linked Research Unit on Health and Social Service Utilization, McMaster University, Faculty of Health Sciences, 1200 Main Street West, HSC-3N46, Hamilton, Ontario, Canada L8N 3Z5
    • The Caroline Medical Group, Burlington, ON, Canada
    • Department of Community Health and Family Medicine, The University of Toronto, Toronto, ON, Canada
  • ,
  • Michael Mills

      Affiliations

    • System-Linked Research Unit on Health and Social Service Utilization, McMaster University, Faculty of Health Sciences, 1200 Main Street West, HSC-3N46, Hamilton, Ontario, Canada L8N 3Z5
    • The Caroline Medical Group, Burlington, ON, Canada
    • Department of Community Health and Family Medicine, The University of Toronto, Toronto, ON, Canada
  • ,
  • Gina Browne

      Affiliations

    • System-Linked Research Unit on Health and Social Service Utilization, McMaster University, Faculty of Health Sciences, 1200 Main Street West, HSC-3N46, Hamilton, Ontario, Canada L8N 3Z5
    • School of Nursing, McMaster University, Hamilton, Ontario, Canada L8N 3Z5
    • Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada L8N 3Z5
    • The Caroline Medical Group, Burlington, ON, Canada
    • Corresponding Author InformationCorresponding author. Tel.: +1-905-525-9140x22293; fax: +1-905-528-5099.
  • ,
  • Meir Steiner

      Affiliations

    • System-Linked Research Unit on Health and Social Service Utilization, McMaster University, Faculty of Health Sciences, 1200 Main Street West, HSC-3N46, Hamilton, Ontario, Canada L8N 3Z5
    • Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada L8N 3Z5
    • The Father Sean O’Sullivan Research Centre, St. Joseph’s Hospital, Hamilton, ON, Canada
  • ,
  • Jacqueline Roberts

      Affiliations

    • System-Linked Research Unit on Health and Social Service Utilization, McMaster University, Faculty of Health Sciences, 1200 Main Street West, HSC-3N46, Hamilton, Ontario, Canada L8N 3Z5
    • School of Nursing, McMaster University, Hamilton, Ontario, Canada L8N 3Z5
    • Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada L8N 3Z5
  • ,
  • Amiram Gafni

      Affiliations

    • System-Linked Research Unit on Health and Social Service Utilization, McMaster University, Faculty of Health Sciences, 1200 Main Street West, HSC-3N46, Hamilton, Ontario, Canada L8N 3Z5
    • Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada L8N 3Z5
    • Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada L8N 3Z5
  • ,
  • Carolyn Byrne

      Affiliations

    • System-Linked Research Unit on Health and Social Service Utilization, McMaster University, Faculty of Health Sciences, 1200 Main Street West, HSC-3N46, Hamilton, Ontario, Canada L8N 3Z5
    • School of Nursing, McMaster University, Hamilton, Ontario, Canada L8N 3Z5
  • ,
  • David Wallik

      Affiliations

    • The Caroline Medical Group, Burlington, ON, Canada
  • ,
  • James Kraemer

      Affiliations

    • The Caroline Medical Group, Burlington, ON, Canada
  • ,
  • Michelle Webb

      Affiliations

    • System-Linked Research Unit on Health and Social Service Utilization, McMaster University, Faculty of Health Sciences, 1200 Main Street West, HSC-3N46, Hamilton, Ontario, Canada L8N 3Z5
  • ,
  • Ellen Jamieson

      Affiliations

    • System-Linked Research Unit on Health and Social Service Utilization, McMaster University, Faculty of Health Sciences, 1200 Main Street West, HSC-3N46, Hamilton, Ontario, Canada L8N 3Z5
  • ,
  • Susan Whittaker

      Affiliations

    • System-Linked Research Unit on Health and Social Service Utilization, McMaster University, Faculty of Health Sciences, 1200 Main Street West, HSC-3N46, Hamilton, Ontario, Canada L8N 3Z5
  • ,
  • Edward Dunn

      Affiliations

    • Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada L8N 3Z5
    • The Father Sean O’Sullivan Research Centre, St. Joseph’s Hospital, Hamilton, ON, Canada

Received 3 April 2002 ,Accepted 28 May 2002.

References 

  1. Akiskal HS. Dysthymic disorder: Psychopathology of proposed chronic depressive subtypes. Am. J. Psychiatry. 1983;140:11–20
  2. Akiskal HS, Costa e Silva JA, Frances A, Freeman HL, Keller MB, Lapierre YD, et al.  Dysthymia in clinical practice: The WPA working group. Br. J. Psychiatry. 1995;166:174–183
  3. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th Edition. Washington, DC: APA; 1994; 349 pp
  4. Beardslee WR, Keller MB, Seifer R, Lavori PW, Staley J, Podorefsky D, et al.  Prediction of adolescent affective disorder: effects of prior parental affective disorders and child psychopathology. J. Am. Acad. Child Adolesc. Psychiatry. 1996;35:279–288
  5. Brawman-Mintzer O, Yonkers KA. Sex differences in the psychopharmacological treatment of depression. In:  Steiner M,  Yonkers K,  Eriksson E editor. Mood Disorders in Women. London: Martin Dunitz; 1999;
  6. Brieger P, Marneros A. Dysthymia and cyclothymia: Historical origins and contemporary development. J. Affect. Disord. 1997;45:117–126
  7. Browne G, Arpin K, Corey P, Fitch M, Gafni A. Individual correlates of health service utilization and the cost of poor adjustment to chronic illness. Med. Care. 1990;28:43–58
  8. Donaldson SK, Klein DN, Riso LP, Schwartz JE. Comorbidity between dysthymic and major depressive disorders: A family study analysis. J. Affect. Disord. 1997;42:103–111
  9. Epstein N, Baldwin L, Bishop D. The McMaster Family Assessment Device. J. Marit. Fam. Ther. 1983;9:171–180
  10. First MB, Spitzer RL, Gibbon M, Williams JBW. Structured Clinical Interview for DSM-IV. New York, NY: Biometrics Research Department; 1996;
  11. Gottfried AW, Guerin D, Spencer JE, Meyer C. Concurrent validity of the Minnesota Child Development Inventory in a nonclinical sample. J. Consult. Clin. Psychol. 1983;51:643–644
  12. Gwirtsman HE, Blehar MC, McCullough JP, Kocsis JH, Prien RF. Standardized assessment of dysthymia: report of a National Institute of Mental Health conference. Psychopharmacol. Bull. 1997;33(1):3–11
  13. Howland RH. General health, health care utilization, and medical comorbidity in dysthymia. Int. J. Psychiatry Med. 1993;23:211–238
  14. Keller MB. Dysthymia: Course, outcome and impact on the community. Acta Psychiatr. Scand. 1994;89(Suppl. 383):24–34
  15. Keller MB, Klein DN, Hirschfeld RM, Kocsis JH, McCullough JP, Miller I, et al.  Results of the DSM-IV Mood Disorders Field Trial. Am. J. Psychiatry. 1995;152:843–849
  16. Kessler RC, Frank RG. The impact of psychiatric disorders on work loss days. Psychol. Med. 1997;27:861–873
  17. Kessler C, Zhao S, Blazer DG, Swartz M. Prevalence, correlates, and course of minor depression and major depression in National Comorbidity Survey. J. Affect. Disord. 1997;45:19–30
  18. Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S, et al.  Lifetime and 12 month prevalence of DSM-III-R psychiatric disorders in the United States. Arch. Gen. Psychiatry. 1994;51:8–19
  19. Klein DN, Riso LP, Donaldson SK, Schwartz JE, Anderson RL, Ouimette PC, et al.  Family study of early-onset dysthymia: mood and personality disorders in relatives of outpatients with dysthymia and episodic major depression and normal controls. Arch. Gen. Psychiatry. 1995;52:487–496
  20. Lane R, McDonald G. Reducing the economic burden of depression. Int. Clin. Psychopharmacol. 1994;9:229–243
  21. Leader JB, Klein DN. Social adjustment in dysthymia, double depression and episodic major depression. J. Affect. Disord. 1996;37:91–101
  22. Montgomery SA, Asberg M. A new depression scale designed to be sensitive to change. Br. J. Psychiatry. 1979;134:382–389
  23. Moos RH, Cronkite RC, Billings AG, Finney JW. Indices of coping. In: Health and Daily Living Form Manual. Palo Alto, CA: Social Ecology Laboratory, Veterans Administration and Stanford University Medical Centre; 1984;p. 16–18
  24. Offord DR, Boyle MH, Szatmari P, Rae-Grant NI, Links PS, Cadman DT, et al.  Ontario Child Health Study: Part II. Six month prevalence of disorder and rates of service utilization. Arch. Gen. Psychiatry. 1987;44:832–836
  25. Ontario Ministry of Health. Ontario Health Survey 1990: User’s Guide. Volume 1. Toronto, Ontario: OMH; 1992;
  26. Shelton RC, Davidson J, Yonkers KA, Koran L, Thase ME, Pearlstein T, et al.  The undertreatment of dysthymia. J. Clin. Psychiatry. 1997;58:59–65
  27. Weinberg MK, Tronick EZ. The impact of maternal psychiatric illness on infant development. J. Clin. Psychiatry. 1998;59(Suppl. 2):53–61
  28. Weissman MM, Prusoff BA, Thompson WD, Harding P, Meyers K. Social adjustment by self report in a community sample and in psychiatric outpatients. J. Nerv. Ment. Dis. 1978;166:317–326
  29. Wells KB, Stewart A, Hayes RD. The functioning and well being of depressed patients: results of the medical outcomes study. J. Am. Med. Assoc. 1989;262:914–919
  30. Williams JW, Barrett J, Oxman T, Frank E, Katon W, Sullivan M, et al.  Treatment of dysthymia and minor depression in primary care: a randomized controlled trial in older adults. J. Am. Med. Assoc. 2000;284(12):1519–1526

PII: S0165-0327(02)00174-X

doi: 10.1016/S0165-0327(02)00174-X

Journal of Affective Disorders
Volume 78, Issue 1 , Pages 73-80 , January 2004